The Voice of Podiatrists

Serving Over 13,500 Podiatrists Daily

November 22, 2011 #4,312 Publisher-Barry Block, DPM, JD

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DC Podiatrist Discusses Compartment Syndrome

Pain on the anterior (outside) part of the lower leg may be compartment syndrome - a swelling of muscles within a closed compartment which creates pressure. To diagnose this condition, special techniques are used to measure the amount of pressure. "With compartment syndrome, the blood supply can be compromised, and muscle injury and pain may occur," says podiatrist Stephen Pribut, DPM, of Washington, D.C. Sometimes surgical "decompression" is required.

Dr. Stephen Pribut

So how do you distinguish compartment syndrome from shin splints? "Symptoms of compartment syndrome include leg pain, unusual nerve sensations and, later, muscle weakness," says Pribut.

Source: Marlene Cimons, Runner's World

CLEAR Obtains Subcontract to Improve Gait Following a Stroke

Scholl College’s CLEAR researchers in collaboration with the physical therapy department at Northeastern University (Boston) obtained a grant from the American Heart Association to explore the effects of dual-task training on attentional and locomotor control in stroke survivors. In addition to maintaining control over their gait, individuals must devote attentional resources to things, such as holding a conversation and avoiding obstacles when walking. Deficits in dual-tasking may severely compromise an individual’s ability to participate fully in community living.

Dr. Bijan Najafi

“The findings from this urgently-needed study will substantially advance the development of physical therapy treatments for stroke because they explore the components of rehabilitation that can minimize potentially-disabling, dual-task interference in stroke survivors,” said Dr. Bijan Najafi, Associate Professor of Applied Biomechanics and site-principle investigator at CLEAR, Rosalind Franklin University of Medicine and Science.

NJ Podiatrist Receives AAPPM's Coveted Egerter Award

Dr. John Guiliana was honored with AAPPM’s most prestigious B.C. Egerter Award for having a lasting national impact on the podiatric world relative to practice management. Guiliana is the managing partner of a podiatric practice in Hackettstown, NJ. He holds a master's degree in healthcare management and is a nationally recognized author and speaker on medical practice management. He is the author of Talking Practice Enhancement, writes news columns for the American Podiatric Medical Association, and is a frequent contributor to Podiatry Management.

Dr. John Guiliana

This award is given annually to those who have unselfishly made a difference for greatly improving podiatry. Past recipients include: Drs. Barry Block, Brad Bakotic and Les Appel. This award is voted upon by the AAPPM’s board of trustees and awarded during their fall seminar. A great part of Dr. Egerter’s life was devoted to helping others in the profession, as do the recipients of the award.

PPMA Installs New President and President-Elect and Presents Awards

Marc Karpo, DPM, Norristown, PA, was installed as the Pennsylvania Podiatric Medical Association’s (PPMA) 2011-2012 President at the House of Delegates Banquet on Saturday, November 12, at the Radisson Valley Forge Hotel, King of Prussia, PA. Karpo recently joined the staff at Temple University School of Podiatric Medicine as an Associate Professor. Joseph Pasquino, DPM, North Huntingdon, PA, was installed as PPMA’s new President-Elect.

Dr. Marc Karpo

PPMA presented several awards including:
Special Recognition Award - Mark E. Pinker, DPM
Award of Excellence - John A. Marty, DPM
Podiatrist of the Year - Kevin T. Naugle, DPM
The Rising Star Award - Michael B. Younes, DPM
The Annual Residency Program Recognition Award - Joseph Watson, DPM 
Edward L. McQuaid Award - Anthony E. Napoli, DPM
Pioneer of Podiatry - Paul J. Creeden, DPM
Special Recognition—Health Practitioner - William P. Dickerman, DO 
Special Recognition—Layperson - Lara Beer-Caulfield, Director of Education and Meeting Planner for the Goldfarb Foundation

MI Podiatrist Indicted in Rx Drug Scheme

Brownstown Township physician Mustak Vaid, 38, and a business associate from Romulus, Arpitkumar Patel, 26, were among more than 20 people, including a podiatrist indicted in connection with an alleged prescription drug scheme. Podiatrist Dr. Anmy Tran, 40, of Macomb, MI, has been indicted after a three-year investigation by law enforcement officials throughout the state.
 
The indictment alleges that Babubhai Patel would offer and pay kickbacks, bribes and other inducements to physicians in order to induce those physicians to write prescriptions for patients with Medicare, Medicaid, and private insurance, and to direct that those prescriptions be presented to one of the Patel Pharmacies for billing. In exchange for their kickbacks and inducements, the medical professionals would write prescriptions for the patients, and bill the relevant insurers for services supposedly provided to the patients, without regard to the medical necessity of those prescriptions and services, according to the DEA.

Source: Lena Khzouz, The News Herald

Editor's Note: PM News is proud to present excerpts from Meet the Masters.

Bret Ribotsky: What are your thoughts on Vision 2015? 

Dr. Eric Hubbard

Eric Hubbard: I think, it’s difficult to do nationally, but if the education improves and we can pass the USMLE, then I think we deserve to get the same degree or comparable degree of a physician and surgeon. There is a history of of orthopedic surgeons not being too friendly towards podiatrists, so we have to make sure that our educational requirements and our education is on par with any other allopathic or osteopathic physicians.

Dr. Edwin Harris

Meet the Masters is broadcast each Tuesday Night at 9 PM (EST). This week's guest is Dr. Edwin Harris, podopediatric expert. You can register for future events by clicking here

Limit E-Mail Responses

Reduce the amount of time you spend replying to e-mail. Adopt these habits:

•  Don’t reply to FYI or CC emails, unless you have something valuable to say.
•  Call instead of write, when it would take longer to convey your thoughts well in writing or you need to have a dialogue with the other person.
•  Delegate responding if someone else is better-suited to handle the message.
•  Add “No reply necessary” to the subject line when you send a message. For close colleagues, you can adopt the code “NRN.”

Source: Adapted from “Should You Respond to Every Email?” Jocelyn K. Glei, 99% via Communication Briefings [December, 2011]

RE: Extra Metatarsal (Joseph Borreggine, DPM)
From: Richard A. Simmons, DPM, Kathy Satterfield, DPM

An x-ray shows what appears to be an accessory, immature metatarsal from the base area of the fourth metatarsal laterally to the space between the fourth and fifth metatarsals, but proximal to their heads. By history, we know that the patient has no pain and the question is, “what to do for it?” My initial response is that you do nothing for it since it is asymptomatic; however, I am curious as to why an x-ray was taken in the first place? Surely the patient presented complaining of something.

Richard A. Simmons, DPM, Rockledge, FL, rasdpm32955@gmail.com

If it doesn't hurt, don't try to 'fix' it. What would be the reason? Why was the radiograph taken in the first place though? This reminds me of treating floaters for ophthalmologists or incidentalomas for nephrologists; they aren't causing trouble yet. Given the breakdown of the medial fifth, it will hurt eventually, and then you are warranted to go in, if necessary.

Kathy Satterfield, DPM, Pomona, CA, vksatterfielddpm@aol.com

RE: Sesamoid Pain Right Foot (Bryan Markinson, DPM)
From: Elliot Udell, DPM
 
Surgical removal of the sesamoids is an option, but such a procedure could cause potential forefoot complications. What you may want to do first is to determine the extent of abnormal pressure beneath the first met head. An inexpensive device is the disposable "Pressure Stat" which is available from Safe Step, Inc. There are  more sophisticated gait analysis devices such as Tekscan.

Even a mild plantarflexed first ray could lead to the above symptoms because the patient has been training for a 26 mile marathon. Overuse, combined with elevated pressure beneath the first met head, could lead to stress fractures and even avascular necrosis. The clinical problem is how to treat it. It would be best to work very closely with the director of an orthotic lab and have him custom design a device that will totally off-load the first met head, and then test the device to make sure that it is really working during walking as well as running. From experience, the orthotic will probably have to be adjusted numerous times until it properly off-loads the affected area.
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

RE: Wavelengths for Laser Treatment of Onychomycosis (David Zuckerman, DPM)
From: Marc Katz, DPM

Long-term studies are needed for all treatments that we offer patients. And company-sponsored trials are the norm in the FDA world, so they are tainted. The wonderfully studied amazing drug Avastin was just pulled off of the market because the studies were questionable, and the drug did not prolong life! A familiar story.

We are talking toenails, not life! Here's the key. This is new technology. Independent studies would be nice and will hopefully happen. However, the public is hot for...
 
Editor's note: Dr. Katz's extended-length letter can be read here.

RE: Sinus Tarsi Implant Surgery (Martin M. Pressman, DPM)
From: John M. Wray, DPM

Whether you call it: flexible flat foot, reducible pes- valgo-planus, or over (hyper) pronation, 718.37 is the exact code to describe this entity. ICD- 9’s definition for 718.3 is “Recurrent dislocation of joint”, and the fifth digit “7” refers to “foot and ankle.”

The “700”series of codes are used for joint derangements, and there is no requirement for trauma to be a component of these codes. To correctly code a traumatic dislocation of a tarsal joint, one would use 838.01 for a closed dislocation or 838.11 for an open dislocation.

If this makes sense to you, as the expert in the field, I encourage you to use 718.37. Most of us have been looking for this code for years. 718.37 - let us tell it like it is.

Disclaimer: I have lectured for GraMedica on the HyproCure Implant.

John M. Wray, DPM, Chicago, IL, jmwray@pol.net

EQUIPMENT FOR SALE - CLASS FOUR LASER- USED K-LASERS

I have used K-laser for sale. Still in Warranty. Used for plantar fasciitis, Achilles tendonitis, neuroma, arthritic conditions and even fungus toe nails This laser is portable, re-chargeable and can be move from room to room or office to office. This isn't the cold laser that you see. It is a 10 watt laser. We have used this laser on NFL sports players. For those that understand a good laser. E-mail David Zuckerman, DPM for Details and pricing. footcare@comcast.net

EQUIPMENT FOR SALE - SUPERPULSE 45 WATT PEAK POWER LASER ( LUMIX2)

Superpulse 45 watt peak power Laser ( lumix2) used once or twice. This is a real superpulse 910nw up to 100,000 HZ. Great Laser Used in the super bowl by the Green Bay Packer Why am I selling? I have too many lasers in my office now ( six) This is a great laser for plantar fasciitis. Achilles tendonitis. Lightweight portable. easy to use, fully programmable Sold to first person under $$12,000 You will NEVER get a laser like this at this price. Enjoy. it I just have too many lasers. David Zuckerman DPM footcare@comcast.net

PRACTICE FOR SALE – NANAIMO, BRITISH COLUMBIA, CANADA

Have you ever dreamed of owning a practice where...you can see 0-50 patients daily * average 100 new patients monthly * have zero accounts receivable * gross $480K per year * live in a beautiful community with skiing, hiking, fishing, and boating on your doorstep. This could be yours! If interested contact pistone@telus.net or call 250-754-4192.

PRACTICE FOR SALE - ARKANSAS
 
Busy, well established practice of 13 years grosses 160K/year for the past 5 years, while working 3.5 days/week. Nursing homes available. 50% Medicare, average of 15 new patients/week. Doctor retiring. Please call 800-983-4194 for more details, or e-mail contactus@podiatrypracticeconsultants.com

Beautiful weather year round & near the Coast. Opportunity for Early Buy-in. Seeking associate or new residency graduate to join practice. Must be PSR-24/36 trained. Multiple locations. Full range of services with new facilities. E-mail cover letter & CV to melissafoot@pol.net

ASSOCIATE POSITION - BAKERSFIELD, CA

Busy surgically-oriented group in Bakersfield, CA searching for 4th doctor. Wound care center privileges. All 3 current surgeons have 3+ years post-graduate training. Send letter of interest with CV to:aghams2@aol.com

ASSOCIATE POSITION - UPSTATE NEW YORK

Outstanding Opportunity. Our medical surgical group is recruiting a well-trained licensed podiatric physician. Located in Beautiful upstate NY. Full hospital privileges, as well as working with two residency programs. Must be highly motivated and great with patients. Opportunity for growth. Competitive salary and benefit package. Please send CV to associateinfoot@yahoo.com

ASSOCIATE POSITION - SOUTH/CENTRAL PENNSYLVANIA

PSR-24/36 trained individual for busy practice in family-friendly college town. Seeking personable, ethical, motivated individual to join our well established practice providing all aspects of podiatric care. Competitive salary and benefits package. Reply with letter, CV and photo to Jagerone@aol.com.

ASSOCIATE POSITION - DAYTON, OH

Join a well-established modern practice in Dayton, Ohio. Excellent reputation and referral base. Base salary $120,000, benefits and bonus structure. EMR, diagnostic ultrasound, Padnet vascular studies, CO2 lasers, all aspects of DME. We seek a surgeon that is well-trained and personable to join our group of 4 podiatric surgeons. Would like to have this individual buy in to the practice eventually. Please send CV and to Ohiodoctors@aol.com

ASSOCIATE POSITION - MARYLAND

Looking for 3rd associate. Must be personable, well trained and highly motivated. Great locations in Southern Maryland, including an Ambulatory Surgical Center. We currently have EHR, digital radiography, dispensing center and PADNet. Looking for immediate hire! Please send CV to: myfeetfeet@aol.com

ASSOCIATE POSITION - EAST TENNESSEE

30 year old practice with 5 offices in greater Knoxville area seeking ethical, personable, hardworking, team player. $160,000 base salary with bonus incentives and benefits. Post-residency experience a plus. Please send resume to ddavidphawk@yahoo.com

ASSOCIATE POSITION - TEXAS

Well established, expanding podiatric medical and surgical practice with multiple locations Northeast of Dallas, Texas. Modern offices with EHR, digital radiography, Padnet vascular studies and laser. We offer a competitive salary and benefits package for a motivated, ethical, personable and well trained PSR/36 or board equivalent. This individual will also assist managing the residency program. Send resume (CV)to northtexaspodiatry@yahoo.com along with a letter of intent

ASSOCIATE POSITION - MARYLAND

Multi-office group seeks highly trained surgical associate to join us. Prefer person with frame and trauma experience. Our practice is state-of-the-art and has all modalities: EMR, PadNnet, on-site billing, diagnostic US, PRP, digital x-ray, etc. Excellent salary, bonus structure and benefits with partnership available. Please forward CV and letter of intent to docsbnb@aol.com

ASSOCIATE POSITION - NORTHWEST IOWA

A well-established, midwest multi-physician practice with strong hospital affiliations seeking FT podiatrist. Applicant should be well trained surgical physician, completed a 24-36 month residency, & board eligible. Practice offers high surgical volume, advanced wound care and good mix of general podiatry. Competitive salary, excellent benefits. Fax resume: 712-258-9977 Diane Coulter, Office Manager

ASSOCIATE POSITION - SOUTHWEST FLORIDA

Immediate position for associate to potential partnership available for a surgeon that is BQ/BC by ABPS. Must be a PSR 24 or PM&S 36 graduate. Salary with bonus. Must be ethical, self starter, hard worker and a team player. Willingness to learn and work as part of a great team is a must. Great ancillaries and surgery facility. Email CV to: susmitad86@yahoo.com

PODIATRY OFFICE TO SHARE - SEATTLE, WASHINGTON

Fully equipped podiatry office in North Gate area of Seattle. Office located in medical professional building near I-5. Office has 3 treatment rooms, 3 physical therapy rooms, direct digital x-ray, PAD- net, NCV testing equipment, physical therapy equipment. Please contact us: website Tel. 425-643-8901 isbinc2006@gmail.com

SPACE AVAILABLE - NYC & LI

Office to sublet and share - East 60th Manhattan, and Plainview, Long Island. access to an MRI, Joint Commission certified operating rooms, digital x-ray, diagnostic ultrasound, and access to a multi-specialty ambulatory surgical center. Also availability E 22nd between 2nd and 3rd and E 70th off 3rd. Turn-key operation - no investment needed 516 476-1815 PODO2345@AOL.COM

PM News Classified Ads Reach over 13,500 DPM's and Students

Whether you have used equipment to sell or our offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 13,500 DPM's. Write to bblock@podiatrym.com or call (718) 897-9700 for details. Weekly ad rates start as low as $109 for a 50-word ad THIS OFFER DOES NOT APPLY TO BUSINESSES PROVIDING PRODUCTS OR SERVICES. Note: For commercial or display ads contact David Kagan at (800) 284-5451.

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